Relationship between polycyclic aromatic hydrocarbons internal exposure and lung function change among healthy college students / 中国学校卫生

Objective@#To investigate the relationship between urinary monohydroxylated metabolites of hydroxyl polycyclic aromatic hydrocarbons (OH-PAHs) and lung function, as well as the role of oxidative stress in these associations, so as to provide a scientific basis for air pollution control and policy formulation.@*Methods@#A panel study was carried out among 45 young healthy adults. Four follow up surveys and health examinations were conducted from November 2017 to October 2018 to measure lung function parameters [forced vital capacity (FVC), second forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), FEV1/FVC, and forced expiratory flow between 25% and 75% vital capacity (FEF 25%~75% )], markers of exposure to 7OHPAHs [∑ 7OH PAHs], and markers of oxidative stress[8 hydroxy 2 deoxyguanosine (8 OHdG) and 8 isoprostaglandin F 2α (8 iso PGF 2α )]. The relationship between urinary PAH metabolites and lung function was quantified by linear mixed effects models. Mediation analysis was performed to assess the role of oxidative stress in the relationship between OH PAHs and lung function.@*Results@#The median values of FVC, FEV1, FEVI/FVC, PEF, and FEF 25%-75% were 4.37 L, 3.58 L, 83.00%, 4.38 L/s, and 3.32 L/s, respectively. The results showed that each 1 unit increase in log transformed value of 2 Hydroxyfluorene (2 OHFlu) was associated with a 5.05% decrease ( β %=-5.05%，95% CI =-8.85%--1.09%) in FVC, 4.15% decrease ( β %=-4.15%，95% CI =-7.94%- -0.22% ) in FEV1 and 5.87% decrease ( β %=-5.87%，95% CI =-11.35%--0.05%) in FEF 25%-75% , respectively. Each 1 unit increase in log transformed values of 2 OHFlu and 9 Phenanthrol (9 OHPhe) was associated with a 7.03% decrease ( β %=-7.03%，95% CI =-12.60%--1.11%) and a 7.08% decrease ( β%=-7.08%，95% CI =-13.50%--0.17%) in PEF, respectively. Additionally, urinary ∑ 7OH PAHs had a positive correlation with the levels of urinary 8 OHdG and 8 iso PGF 2α ( r =0.64, 0.69, P <0.01). Meanwhile, the levels of 8 OHdG mediated 17.06% and 15.71% of the association between 2 OHFlu with FVC and FEV1.@*Conclusion@#The finding reveales a negative relationship between urinary OH PAHs and lung function among young healthy adults. The 8 OHdG plays a mediated role in the correlation of 2 OHFlu with FVC and FEV1. Active relevant policies are needed to control air pollution and maintain the healthy living conditions of young people.

Risk factors and interventions for surgical failure of spinal tuberculosis / 中华骨科杂志

Objective:To investigate the risk factors and interventions for surgical failure of spinal tuberculosis (STB).Methods:A total of 317 STB patients aged from 11 to 86 years with an average age of 53.5±16.7 years, who received debridement and fusion with bone grafting from January 2013 to December 2019, were retrospectively analyzed, including 206 males and 111 females. The follow-up duration was at least 1 year. During the follow-up, any one of the following 1)-3) was defined as surgical failure, namely 1) the same tubercular lesion treated by surgery more than 2 times, 2) the number of unplanned readmissions related to tubercular lesion≥1, 3) drug-resistant STB or delayed healing, recurrent lesion with cold abscess/sinus tract, combined with other bacterial infection, or loosening of internal fixation. The other cases were regarded as "curative" cases. Patients' symptoms, medication history, auxiliary examination and surgical plan were collected for univariate analysis. Further, the potential risk factors for surgical failure were analyzed by binary Logistic regression. Failed cases were treated with etiological intervention, such as puncture pumping pus or debridement or revision. The necrosis or granulation tissue was collected and further detected by tuberculosis culture, metagenomic next-generation sequencing (mNGS) and real-time fluorescent quantitative PCR (RT-qPCR).Results:There were 27 cases with surgical failure. Abscess or sinus tract formation was developed in 17 cases, which accounted for 63% (17/27). Among these patients, there were 3 cases of resistance to isoniazid or rifampicin and 2 cases of resistance to isoniazid and rifampicin (multidrug resistance, MDR). Seventeen cases were treated by anti-tuberculosis treatment, while 14 cases by puncture drainage (or puncture catheter irrigation) and 3 cases by debridement and suturing. Seven cases with wound infection or poor healing accounted for 26% (7/27). Among them, 5 kinds of pathogens were detected, none of which showed tuberculosis drug resistance. All of them were treated by anti-infection and debridement suturing, while 2 of them were treated with internal fixation removal. Three cases (11%, 3/27) with internal fixation loosening were treated by revision surgery. There was statistically significant difference between the failed group and the cured group in involved multi-/jumping segment, history of type 2 diabetes, a history of more than three basic diseases, CRP at one week after surgery, WBC at one week after surgery, time of first dose, operation duration and intraoperative blood loss ( P<0.10). Binary Logistic regression analysis showed that multi-/jumping segment ( OR= 3.513, P=0.047), CRP at one week after surgery ( OR=1.021, P=0.005), first dose time ≥20 weeks ( OR=2.895, P=0.039), blood loss ≥800 ml ( OR=5.950, P=0.001) and more than three basic diseases involved ( OR=3.671, P=0.027) were independent risk factors for surgical failure. Conclusion:Early diagnosis, especially the diagnosis of drug-resistant STB and standardized anti-tubercular treatment, should be carried out effectively. Puncture and drainage of abscess is an effective therapy to treat the cases with abscess/sinus tract formation. Some cases involved multi-/jumping segments could be with higher risk of failure after internal fixation. Thus, they should be treated individually with emphasis on the segmental stability reconstruction.

Application of decision tree model in predicting the risk of hypothermia after cardiopulmonary bypass in children with congenital heart disease / 中华实用儿科临床杂志

Objective:To analyze the influential factors of hypothermia in congenital heart disease (CHD) after cardiopulmonary bypass (CPB) rewarming using the decision tree model, thus providing theoretical basis for medical staff.Methods:A total of 711 CHD children who underwent surgery in the Shanghai Children′s Medical Center from January 1, 2019 to April 30, 2019 were retrospectively analyzed.A decision tree model was established to predict the risk factors for hypothermia in CHD children following CPB.Results:The decision tree model showed that CPB program, preoperative nutrition score and body surface area were the high-risk factors for hypothermia in CHD children after CPB rewarming.The accuracy, sensitivity, specificity of the decision tree model were 86.45%, 77.14% and 90.97%, respectively, and the area under the receiver operating characteristic curve was 0.851(95% CI: 0.798-0.904). Conclusions:Decision tree model has a high application value in predicting hypothermia in CHD children following CPB.It contributes to identify the influential factors of hypothermia, and provides references for performing preventive treatment and nursing measures to control the risk of hypothermia.

Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (version 2022) / 中华创伤杂志

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

Spinal endoscopy via percutaneous transforaminal approach for lumbar posterior ring apophysis separation / 中华创伤杂志

Objective@#To investigate the clinical efficacy of spinal endoscopic surgery for lumbar posterior ring apophysis separation (PRAS) via percutaneous transforaminal approach.@*Methods@#A retrospective case series study was conducted to analyze the clinical data of 32 patients with lumbar PRAS admitted to the First Affiliated Hospital of Fujian Medical University from September 2016 to March 2018. There were 20 males and 12 females, aged 20-47 years [(33.7 ± 6.6)years]. All patients had single-segment lesions. The injured segments were at L3/4 in seven patients, L4/5 in 14 patients, L5/S1 in 11 patients. All patients were treated with spinal endoscopic surgery via percutaneous transforaminal approach. The incision length, operation time, intraoperative blood loss, intraoperative fluoroscopy times of C-arm X-ray machine and operational complications were recorded. At 24 hours, 3 months and 12 months after operation, the efficacy was evaluated by visual analogue score (VAS), Oswestry dysfunction index (ODI) and modified MacNab criteria.@*Results@#All patients were followed up for 12-30 months, with an average of 15.5 months. The incision length was 7-9.5 mm [(8.0±0.9)mm], the average operation time was 60-155 minutes [(80.5±13.2) minutes], the average intraoperative blood loss was 5-25 ml [(10.6±5.7)ml] and the average number of fluoroscopy was 5-25 times [(9.4±3.4) times]. The patients were permitted to move wearing hard waist 8-12 hours after operation and returned to normal work and life 6 weeks after operation. Postoperative dysesthesia was noted in one patient, who recovered after neurotrophy and physiotherapy after one week. There were no complications such as open surgery conversion, intervertebral space infection, nerve root injury and dural sac laceration. The VAS and ODI at 24 hours, 3 months and 12 months after operation [low back pain VAS: (3.4±1.5)point, (1.8±1.1)points, (1.7±0.9)points; leg pain VAS: (1.8±1.0)points, (1.6±0.8)points, (1.4±0.6)points; ODI: (26.8±9.7)%, (13.9±4.3)%, (12.8±2.8)%] were significantly improved compared with those before operation [ back pain VAS: (7.3±2.1)points, leg pain VAS: (7.9±2.7)points; ODI: (56.2±15.6)%] (P<0.05). According to the modified MacNab criteria, the results were excellent in 25 patients, good in five patients, and fair in two patients, with the excellent and good rate of 94%.@*Conclusion@#Spinal endoscopic surgery for lumbar PRAS via percutaneous transforaminal approach is an effective method with advantages of small incision, less complications, effective pain relief and fast functional recovery.

Spinal endoscopy via percutaneous transforaminal approach for lumbar posterior ring apophysis separation / 中华创伤杂志

Objective To investigate the clinical efficacy of spinal endoscopic surgery for lumbar posterior ring apophysis separation (PRAS) via percutaneous transforaminal approach.Methods A retrospective case series study was conducted to analyze the clinical data of 32 patients with lumbar PRAS admitted to the First Affiliated Hospital of Fujian Medical University from September 2016 to March 2018.There were 20 males and 12 females,aged 20-47 years [(33.7 ± 6.6)years].All patients had singlesegment lesions.The injured segments were at L3/4 in seven patients,L4/5 in 14 patients,L5/S1 in 11 patients.All patients were treated with spinal endoscopic surgery via porcutaneous transforaminal approach.The incision length,operation time,intraoperative blood loss,intraoperative fluoroscopy times of C-arm X-ray machine and operational complications were recorded.At 24 hours,3 months and 12 months after operation,the efficacy was evaluated by visual analogue score (VAS),Oswestry dysfunction index (ODI) and modified MacNab criteria.Results All patients were followed up for 12-30 months,with an average of 15.5 months.The incision length was 7-9.5 mm [(8.0 ±t 0.9) mm],the average operation time was 60-155 minutes [(80.5 ± 13.2) minutes],the average intraoperative blood loss was 5-25 ml [(10.6 ± 5.7) ml] and the average number of fluoroscopy was 5-25 times [(9.4 ±3.4) times].The patients were permitted to move wearing hard waist 8-12 hours after operation and returned to normal work and life 6 weeks after operation.Postoperative dysesthesia was noted in one patient,who recovered after neurotrophy and physiotherapy after one week.There were no complications such as open surgery conversion,intervertebral space infection,nerve root injury and dural sac laceration.The VAS and ODI at 24 hours,3 months and 12 months after operation [low back pain VAS:(3.4 ± 1.5) point,(1.8 ± 1.1) points,(1.7 ± 0.9) points;leg pain VAS:(1.8 ± 1.0) points,(1.6 ±0.8)points,(1.4±0.6)points;ODI:(26.8 ±9.7)％,(13.9 ±4.3)％,(12.8 ±2.8)％] weresignificantly improved compared with those before operation [back pain VAS:(7.3 ± 2.1) points,leg pain VAS:(7.9 ± 2.7) points;ODI:(56.2 ± 15.6)％] (P ＜ 0.05).According to the modified MacNab criteria,the results were excellent in 25 patients,good in five patients,and fair in two patients,with the excellent and good rate of 94％.Conclusion Spinal endoscopic surgery for lumbar PRAS via percutaneous transforaminal approach is an effective method with advantages of small incision,less complications,effective pain relief and fast functional recovery.

Evaluation of different laboratory methods for auxiliary diagnosis of pulmonary tuberculosis / 临床检验杂志

Objective@#To evaluate the effectiveness of different laboratory methods for the supplementary diagnosis of pulmonary tuberculosis（PTB）and provide reference data for the early diagnosis of PTB. @*Methods@#A total of 298 suspected PTB patients, who were diagnosed and treated in the outpatient department of Shanghai Tongren Hospital from January 2016 to December 2018, were divided into 3 groups: active PTB (138 cases)，inactive PTB (43 cases) and non-PTB (117 cases) group. Sputum acid-fast staining, MGIT liquid culture system and Xpert MTB/RIF test were performed to detect the sputum specimens. The sensitivity and specificity were compared by Chi-square test. @*Results@#The three methods showed certain significance for distinguishing active PTB, inactive PTB combined with non-PTB (χ 2 values were 89.08, 138.94 and 137.12 respectively, all P＜0.01). There was no significant difference for the positive rate of the three methods between inactive PTB and non-PTB. The sensitivities of acid-fast staining, MGIT liquid culture, Xpert MTB/RIF test and the combination of three methods in the diagnosis of active PTB were 45.7% (63/138), 63.8% (88/138), 65.4% (87/133) and 78.2% (104/133) respectively. The sensitivities of MGIT culture and Xpert MTB/RIF test were significantly higher than that of acid-fast staining (χ 2 was 35.79 and 11.26 respectively，all P＜0.01). There was no significant difference for the sensitivities between MGIT liquid culture and Xpert MTB/RIF test（χ 2 was 29.87, P＞0.05) . The sensitivity of combined detection was higher than that of single detection（χ 2 was 30.84, 64.62, 70.14, respectively, all P＜0.01）. The diagnostic specificities of the three methods and their combination were 99.1%（116/117), 98.3%（115/116）, 99.1%（113/114) and 97.3%（110/113）respectively. There was no significant difference for the specificities of the three methods. @*Conclusion@#High sensitivities of MGIT liquid culture and Xpert MTB/RIF test were shown in PTB diagnosis. Combined detection of the three methods may improve the sensitivity of detection.

Assessment of serum GP73, AFP-L3, AFP and AFU detection in the diagnosis of hepatocellular carcinoma / 中华检验医学杂志

Objective Explore the clinical application values of Golgi Protein 73 ( GP73 ) , AFP variants (AFP-L3) , Alpha fetoprotein ( AFP) and α-l-Fucosidase ( AFU) detection in the diagnosis of hepatocellular carcinoma ( HCC) .Methods From January of 2013 to June of 2014, 84 case of HCC Patients( HCC group ) who presented at interventional department; 64 case of cirrhotic patients ( liver cirrhosis group ) , 86 case of chronic hepatitis patients ( chronic hepatitis group ) and 120 healthy people ( normal control group) were selected from Shanghai Tongren Hospital.GP73 was detected by the enzyme-linked immunosorbent assay (ELISA), AFP-L3 was isolated with ACSC, AFP and AFP-L3 were detected with ECLIA and calculated the percentage content of AFP-L3 ( AFP-L3%) , AFU was detected with enzyme kinetic method.Adopted the SPSS 19.0 statistical software for data analysis.The rank sum test was used in the multi group comparison;the chi square test was used in the comparison group.Results Serum levels of GP73, AFP-L3, AFP and AFU in HCC group were 202.1 μg/L, 9.5%, 68.3 μg/L, 33.2 μg/L respectively.Their difference from those of the normal control group(69.0 μg/L,2.5%,4.5 μg/L,24.2μg/L) was of statistical significance (U was 1126.59, 204.67,1247.68,564.08,respectively,all P 0.05) Sensitivity of GP73 and AFP in individual inspection was 95.24%, significantly higher than that of AFU, AFP-L3. Specificity of AFP-L3 was 94.81%respectively, with an accuracy of 85.88% respectively.Specificity and accuracy of the allied detection of GP73, AFP-L3, AFP and AFU for HCC diagnosis were 98.52% and 84.75% respectively.Conclusions The allied combination of serum GP73, AFP-L3, AFP and AFU makes up for the insufficient clinical applications of individual serum markers. It is of great clinical significance to improve the diagnosis of HCC.

Modified transforaminal lumbar interbody fusion for acute and chronic lumbar intervertebral disc injury via minimally invasive expandable access system / 中华创伤杂志

Objective To evaluate outcomes of modified transforaminal lumbar interbody fusion (TLIF) assisted by the minimally invasive expandable access system and spinal channel endoscope for acute and chronic lumbar intervertebral disc injury.Methods From March 2013 to November 2014, 45 patients with lumbar intervertebral disc injury were managed with minimally invasive (Group A) or open TLIF (Group B).Location for disc injury was at L3/4 in 5 patients, L4/5 in 28 patients and L5-S1 in 12 patients.Group A composing 12 males and 10 females showed age of (53.70 ±3.59) years (range, 43 to 67 years).Group B composing 14 males and 9 females showed age of (54.80 ± 4.37) years (range, 42 to 68 years).Between-group comparison was conducted with respect to operation time, blood loss, postoperative drainage loss, ambulation time and postoperative complications.Clinical outcomes were evaluated using the visual analogue scale (VAS), Oswestry dysfunction index (ODI), and bone fusion rate.Results Except for the comparable operation time, group A was associated with better results in the blood loss [(152.1 ± 15.5) ml vs (409.9 ± 28.3) ml], drainage volume [(106.1 ± 14.3)mlvs (223.0 ± 19.4)ml], ambulation time[(4.5 ±1.1)d vs (8.9 ±1.4)d] and 1-week postoperative VAS [(3.0±0.7) points vs (4.7 ±0.4) points] (P ＜0.05).At the final follow-up, VAS and ODI of both groups were significantly improved compared to the preoperative levels (P ＜ 0.05), but the differences between groups were insignificant (P ＞0.05).Bone fusion rate in Group A was 95％ (21/22) versus 96％ (22/23) in Group B 6-month postoperatively (P ＞ 0.05).No nerve root injury, intervertebral space infection or other complications occurred.Conclusion Modified TLIF assisted by the minimally invasive expandable access system offers the benefits of less trauma, less bleeding and a quicker recovery for acute and chronic lumbar intervertebral disc injury and has similar long-term clinical outcomes with open TLIF.

Design of military hospital bonus accounting system based on B/S architecture / 医疗卫生装备

To design a military hospital bonus accounting system. The system used Java as the fore-ground development tool and SQL Server 2005 as the background database, which extracted data from the military hospi-tal cost accounting management system to calculate the bonus with some formula. The system had four functional modules to complete department benefit accounting, bonus calculation, bonus summarization and bonus inquiry. The system decreases the workload and contributes to the standardized management of the accounting.

Study on the relationship between serum Estradiol andβ-amyloid protein in patients with cerebral infarction / 国际检验医学杂志

Objective To study the relationship between serum Estradiol(E2 ) andβ-amyloid protein(β-AP) in patients with cer-ebral infarction .Methods A total of 46 female patients with cerebral infarction were selected from 2011 January to 2014 June into observation group ,46 cases were divided as 20 cases in mild group ,16 cases in moderate group ,10 cases in severe group on the basis of neural function defect score standard ,according to the size of infarct volume 46 patients were divided into small infarct volume group with 21 patients ,moderate infarct volume group with 14 cases ,larger infarction volume group with 11 cases .In the same peri-od ,64 healthy women were recruited into control group .Serum E2 ,β-AP levels of serum and cerebrospinal fluid were detected and compared ,and the relationship of serum E2 andβ-AP level in serum ,cerebrospinal fluid were analyzed .Results Theβ-AP levels in serum and cerebrospinal fluid in observation group were higher than those of control group ,the serum E2 level was significant lower than that of the control group ,the differences were significant(P0 .05) .The expression of serum E2 andβ-AP in serum and cerebrospinal fluid were negatively correlated(r= -0 .428 ,P=0 .009;r= -0 .476 ,P=0 .005) .Conclusion β-AP levels in serum and cerebrospinal fluid in patients with cerebral infarction are high ,closely related with the severity of cerebral in-farction .β-AP levels of cerebrospinal fluid ,serum in cerebral infarction patients are negatively related to the level of serum E2 .

Disinfectant-resistant gene of methicillin-resistant St ap hy lococcus aureus / 中国感染与化疗杂志

Objective To understand the prevalence of disinfectant-resistant gene qacA/B in the clinical strains of methicillin-resistant Staphylococcus aureus (MRSA) .Methods A total of 123 clinical consecutive MRSA strains were collected for PCR assay to detect qacA/B gene and mecA gene .Results The qacA/B gene was identified in 19 (15 .4% ) of the 123 MRSA strains . The mecA gene was positive in 89 .4% (110/123) of the MRSA strains .Conclusions The disinfectant-resistant gene qacA/B is prevalent in the hospital-acquired MRSA strains .Monitoring measures should be strengthened for appropriate selection of disinfectants in clinical practice .

Evaluation of real-time fluorescent quantitative PCR and cefoxitin screening test in detection of methicillin-resistant Staphylococcus aureus / 国际检验医学杂志

Objective To evaluate the cefoxitin screening test in detecting(MRSA)with the real-time fluorescent quantitative polymerase chain reaction(RT-PCR)for detecting mecA gene as the golden standard.Methods Staphylococcus aureus strains iso-lated from various bacterial infection specimens were collected,which were amplified by RT-PCR and detected by the cefoxitin screening test respectively.The results were compared.Results In 121strains of MRSA,66 strains carrying mecA gene were detec-ted by RT-PCR(P >0.05),accounting for 54.55%(66/121).There was no statsitcal difference in the detection results between the cefoxitin screening test and RT-PCR.The sensitivity of the cefoxitin screening test was 93.93%,the specificity was 81.82%,the positive predictive value was 84.93% and negative predictive value was 91.83%.Conclusion The RT-PCR technique can accurate-ly and rapidly detect MRSA.

Atlantoaxial pedicle screw system for treatment of unstable atlantoaxial dislocation post traction / 中华创伤杂志

Objective To explore the technique and clinical outcome of the atlantoaxial pedicle screw system in the treatment of the unstable atlantoaxial dislocation post traction.Methods The study involved 32 patients with atlantoaxial dislocation(type T2 of TOI classification)admitted from March 2005 to September 2009.There were 17 patients with fresh odontoid fracture and two with old odontoid fracture,five with traumatic disruption of the transverse atlantal ligament and eight with congenital odontoid dysplasia.JOA scores of neurological function before operation was at a range of 5-13(average 8.38).The average of space available for the cord(SAC)was 9.15 mm.Before the atlantoaxial pedicle screw system was carried out,the skull traction was performed in all the patients preoperatively.Results A total of 128 pedicle screws were inserted safely,with mean operation time and perioperative blood loss for 1.5 hours and 300 ml,respectively.No injury to the vertebral artery or spinal cord was observed.All the patients were followed up for 12-24 months,which showed that JOA scores one year after operation was increased to 10-17(average 14.56),with the improvement rate of 71.70%,and that the SAC was average 14.86 mm.The X-ray and SCT scans verified the proper position of the screws,with no internal fixation failure or atlantoaxial redislocation.After 3-6 months,all the patients except for one patient achieved a solid bone fusion.One year after operation,the one patient with no bone graft fusion was removed of the internal fixation system and obtained satisfactory restoration of the rotational function.Conclusions Atlantoaxial pedicle screw system is an effective method for the treatment of the unstable atlantoaxial dislocation post traction,for it has the advantages of stable three-dimension fixation,direct screw placement,intraoperative reduction and high fusion rate.

Treatment options for Grauer type Ⅱ odontoid fractures and clinical outcome / 中华创伤杂志

ObjectiveTo explore the treatment options for fresh Grauer type Ⅱ odontoid fractures and discuss corresponding clinical outcome.Methods The study involved 40 patients with fresh odontoid fractures including seven with type Ⅱ A fractures, 18 with type Ⅱ B and 15 with type ⅡC according to Grauer classification.There were five patients with incomplete cervical cord injuries.Type Ⅱ A fractures were treated by traction of occipital-jaw band or skull for 1-2 weeks and then fixed with head-neck-chest plaster or brace.Type Ⅱ B fractures were treated with anterior odontoid screw system fixation.Fifteen patients with type Ⅱ C fractures and three patients with type Ⅱ B fractures combined with severe fracture displacement were managed with posterior atlantoaxial pedicle screw fixation.Results All the patients were followed up for 6-24 months.Seven patients with type Ⅱ A fractures showed union after fixation with head-neck-chest plaster or brace for 3-6 months.Fifteen patients treated with odontoid screw fixation had good positions of screws, with no injury to the spinal cord, of which 14 patients obtained bone union, with union rate of 93.3％.Eighteen patients (including 15 patients with type Ⅱ C fractures and three with type Ⅱ B fractures combined with severe displacement) managed with atlantoaxial pedicle screw system showed no injury to the vertebral artery and spinal cord.Solid bone fusion was achieved.in 31 patients after 3 to 6 months.The X-ray and SCT scans verified proper fixation of the screws, with no deformation, loosening or breakage of the screws.Five patients with incomplete cervical cord injuries obtained neural function recovery at various degrees after surgery.ConclusionsConservative treatment cau be alternative to type ⅡA fractures.Anterior odontoid hollow screw fixation is better for type ⅡB fractures (non-displaced or reducible) and has advantages of minor trauma, fast postoperative recovery and high union rate.However, posterior atlantoaxial pedicle screw system fixation and fusion is suitable to type Ⅱ C and ⅡB fractures with severe displacement and has the advantages of stable three-dimension fixation, direct screw placement, intraoperative reduction, short-segment fixation and high fusion rate.

Effects of low dose Glibenclamide on secondary damage after acute spinal cord injury in rats / 中华骨科杂志

Objective To investigate the effects of Glibenclamide on reduction of secondary damage after acute spinal cord injury in rats.Methods Ninety rats were randomly divided into control group (laminectomy alone),spinal cord injury group(injury group),and treatment group(treated with Glibenclamide after spinal cord injury),with 30 rats in each group.The pathological morphology changes of injured spinal cord were observed by HE staining and electron microscope.The expressions of sulfonylurea receptor 1 (SUR1)were detected by immunohistochemical method at 45 min,6 h,24 h,3 d and 7 d after spinal cord injury,and IPP 6.0 software were used for quantitative analysis.The function recoveries of the hind limbs of rats were evaluated by BBB score.The blood sugar level was detected quantitatively.Results HE staining showed that tissue bleeding and microglia proliferation getting severe with time after spinal cord injury.Compared to the injury group,tissue bleeding,microglia proliferation and inflammatory cell invasion was less severe in treatment group.Showed by electron microscope,inflammatory cell invasion,myelin sheath layer structure damage and mitochondrial swelling were significantly reduced after Glibenclamide treatment.Detected by immunohistochemical staining,the expressions of SUR1 at all time points after injury,except for 45 min that there were no SUR1 expressions in all groups,were much weaker in the treatment group than in the injury group.The SUR1 expression reached the peak at 24 h after injury in injury group,and decreased gradually with time.Significant differences were found in the SUR1 expression among three groups by oneway ANOVE.The BBB scores of treatment group were significant higher than that of injury group.The blood sugar slightly decreased in the treatment group,while no significant difference was found among three groups.Conclusion Glibenclamide can significant reduced the secondary damage after acute spinal cord injury.The protection of Glibenclamide after spinal cord injury may relate to its suppression of SUR1.

Dynamic change of parasites in the brains of BALB/c mice infected with Angiostrongylus cantonensis / 中国人兽共患病学报

To observe the dynamic change of parasites in the brains of BALB/c mice infected with Angiostrongylus cantonensis in order to explore its possible mechanism of pathogenesis', BALB/c mice infected with the III stage larvae of A.cantonensis were observed and killed in different times after infection. The number and distribution of parasites in the brains of the infected mice were observed microscopically and macroscopically. It was found that the larvae of A.cantonensis were distributed in the cerebrum and cerebellum of mice in accordance with the rule of parasitization of worms in the host, i.e.multiplication at first and then dropping in number. And the places where the parasites located were damaged due to mechanical action or inflammatory reactions. The time of onset of symptoms, such as ataxia and twitch was coincided with the dynamic changes in the brains of the infected mice.

Feasibility of repairing bone defect of rabbit radius by autologous bone marrow stromal stem cells / 中国组织工程研究

BACKGROUND: There is no effective measure to repair the large scope bone defect in clinic till now.OBJECTIVE: To explore the feasibility on repairing bone defect of rabbit radius by autologous bone marrow stem cells.DESIGN: Self-controlled groping study focused on experimental animals.SETTING: Department of orthopaedics of a university hogpital.MATERIALS: The study was completed in the Experimental Animal Centre of Fujian Medical Science Institute. Twelve healthy New Zealand rabbits with half sex each were selected with body mass of 3.1 to 3.4 kg.METHODS: The marrow of rabbit ilium was collected and separated, cultured in vitro to prolifeiate bone marrow stromal stem cells and then mixed with biological materials to transplant the distal bone defect area of rabbit radius. X-ray, gross samples and histological section were used to observe the repairing effects.ture of bone marrow stromal stem cellsRESULTS: X-ray showed that new bone with high density was formed 12weeks after transplant and white cortical bone was seen in the defected area from gross sample while histological sections showed that there were plenty of bone trabecules and the marrow cavity was formed.CONCLUSION: Transplant of autogenous bone marrow stromal stem cells is an ideal method to repair distal bone defect of rabbit radius.

The changes and significance of serum cytokine in rats with acute necrotizing pancreatitis / 中国医师杂志

Objective To explore the changes and significance of serum tumor necrosis factor-?(TNF-?),interleukin-1?(IL-1?),IL-6 and IL-10 in rats with acute necrotizing pancreatitis(ANP).Methods Sixty-four Wistar rats were randomly divided into 2 groups: sham operation group(SO group n=32) and ANP group(n=32).The ANP model was established by using retrograde injection of Sodium Taurocholate into cholangiopancreatic duct.The changes of serum endotoxin(ET),TNF-?,IL-1?,IL-6 and IL-10 in different groups and different time points were observed.Results The levels of serum ET,TNF-?,IL-1?,IL-6 and IL-10(except IL10 of ANP group in 16h) in rats of ANP group were significantly higher than those of SO group(P

Applied anatomy on transposition of the vascularized periosteal flap with dorsal branch of anterior interossea vessel / 中华显微外科杂志

Objective The investitgation of vascularized periosteal flap with dorsal branch of anterior interossea vessel was performed to provide anatomical basis for periosteal flap transposition. Methods The courses, branches, distribution and anastomosis of the dorsal branch of anterior interossea vessel were observed on 30 sides of adult cadavers' upper extremities and stimulated operation were perfomed. Results The dorsal branch penetrate out of interosseous membrane of forearm at (6. 6? 1. 4) cm upper the styloid process of the radius. It also sent off branches to the dorsal of ulna and radius that consist the periosteal flap. The dorsal branch send off lateral and medial branch about (2. 6?0. 8) cm upper the styloid process of the radius. The end of the branch anastomoses with dorsal carpal branch of the ulnar and radial vessel' Conclusion The pedicled osteoperiosteal flap can be transferred for repairing the fracture nonunion of ulna and radius and transpose reversely to repair scaphoid and innate bone disease'